Kentucky's Worker Shortage

How do we address Paramedic shortages in rural communities?

In the latest episode of Registry Insider, Bill Seifarth speaks with Deputy Chief Phillip Ferguson and EMS Educator Michael Cornett of Hopkinsville Fire and EMS about an innovative training model that expands access to Paramedic education across Kentucky while maintaining rigorous educational standards.

By bringing instruction closer to where students live and work, their program has helped develop more than 60 new Paramedics in just over a year and created a sustainable pipeline for rural EMS agencies.

Tune in as they discuss the challenges facing rural EMS, lessons learned, and opportunities to strengthen the future workforce.

Transcript

SPEAKER_01 0:15

Welcome to the Ridge Insider. I'm Bill Seiferth from the National Ridge to EMTs, and today we're filming from Acredicon, which is taking place down in New Orleans, Louisiana. Joining me today are two actually presenters here at Acredicon, Phil Ferguson and Mike Cornette from Hopkinsville Fire and EMS in Kentucky. And both of them, first of all, thank you for joining me for today's episode to talk about a challenge that's not necessarily unique to Kentucky, but certainly was remedied, fixed, addressed in some pretty innovative and creative ways. So thank you both for joining me. Thank you for having us. So if you wouldn't mind, uh Phil, if you could just tee it up a little bit to talk about how challenging the situation was in Kentucky, and then we'll kind of get into what you did that was innovative and how it worked for uh for the benefit, certainly of y'all, but but more important citizens in Kentucky.

SPEAKER_00 1:09

Yeah, sure. Um so Kentucky is one of the lowest producing states from a initial paramedic perspective or standard. Uh um so what we had to do is we we basically said, how can we get uh more medics, get the education to the student, and uh basically take an accredited program and put it in multiple communities across the state.

SPEAKER_01 1:35

As far as the state goes, I'm sorry, you're in overview, as far as state goes, there's I think 120 counties.

SPEAKER_00 1:40

Oh yes, there's 120 county, 120 counties in the state, and of those uh serving 120 counties, there's 22 training institutions that are licensed in the state of Kentucky. So between those 22 institutions, they produce about uh 100 to 130 students per year. That's about six or seven per per program, and that's just not enough to sustain what we were losing. We lose about 100 to 110 students, sorry, 100 to 110 paramedics uh on an annual basis going into a different field or just not renewing their license and getting staying in the field uh itself. So we're not even keeping our head above water. No, and so we had to find a different way to to reach the students that don't uh have the ability to reach that uh traditional model. And uh through some uh some things with the workforce committee with Kentucky Board of EMS, I'm actually the chair of that that committee, uh, and through some conversations we decided, you know what, let's um let's try something bold, let's do something different to try to meet this this demand. Because I I've always thought there was uh student interest out there. You know, you you hear people all the time say that there's there's not enough interest. People don't want to go from EMT or advanced EMT to paramedic. But I I didn't I don't really believe that, honestly. I felt like there was a lot of students out there that wanted to be paramedics, but they just didn't have the access. So what we decided to do is try to attack the barriers that we we found that prevented people to become paramedics and try to remove those barriers. And this is one of the models that we came up with.

SPEAKER_01 3:14

Excellent. Um, and Mike, so uh this is your role as lead instructor. What from your perspective, what were the some of the I guess let's talk about the barriers first and then we'll talk about the solutions. What were some of those barriers? Because some of them were perceived regulations or some information that was just not necessarily 100% accurate.

SPEAKER_00 3:34

That's definitely true. Um, from the student perspective, the barriers that we found was the lack of flexibility. That's one of the one of the things. Uh, you know, not every student, especially in EMS, most of our our students are non-traditional students who are supporting a family, who are working two jobs, that are uh trying to go to med school, and that alone is a lot for an adult edu adult student. Now you're trying to take that same student, but in a rural community, we're literally asking them to uproot their life from this rural community and travel two, three, four counties over to a paramedic program every Monday, Thursday, and that just wasn't working.

SPEAKER_01 4:15

And plus, they have to do clinicals on top of it.

SPEAKER_00 4:18

That's right, that's right. Pride time exactly, exactly. And so here's the thing we we put out there an information session, and we said, okay, how many people want to attend this information session? And let's see if we have interest. And it blew me away. We had over 250 attend an information session, we had 179 apply for the program, and we accepted 110 students. That in and itself shows there's a demand out there. We just got to remove the barriers and give them the access that they they they need to to be able to attend the program.

SPEAKER_01 4:52

So uh, Mike, highlight for us some of the the solutions to some of the barriers, uh, the access. How did you how did you overcome that?

SPEAKER_03 5:01

So we use a uh uh will and spoke model. Basically, what we do is we do our centralized education there in Hopkinsville Fire and EMS, and then we have our alternative sites that uh that teach the the skills portion and uh allow the students to come in, uh, whether they're in-house or outside students, they come in and they can do these different skills tests and mandatory skills days. Uh we're not reducing standards, we're we're just expanding the way that those standards look. Um and they come in and they they do these different tests every single, you know, on these mandatory days to make it better is one of the what one of the skills ways. Um another one way that we do it is um again that centralized education we do via Zoom. So a student can attend live in the in the hypergel classroom. So synchronous is synchronous. They can attend uh asynchronously at one of the alternative sites, or the student may have worked 24 hours the night before, they're not gonna get anything out of it, so we record every lecture that we do, so they can also do it as an asynchronous program. So and then we have sta uh minimum standards that they have to be done by this time to make sure that we are progressing as we need to and make sure that the students are progressing as they need. Excellent.

SPEAKER_00 6:22

So um, when was your first program? We started in uh January of 25. Okay. And the didactic portion ended in November of 25. And we had licensed paramedics working on the trucks within a year. Wonderful. Most of our cohort uh is now wrapping up. Their internship uh deadline is actually the 31st of this month of May. And uh our numbers are we're we're ecstatic about it. It's it's we were we've already got 60 plus paramedics that are licensed working across Kentucky and in communities that were really suffering. What really makes it uh uh publicly makes it even better is these same partners that we partnered with last time, they've signed up again for the next cohort, which starts in August of 26th. And we've gained already six more new partners. Excellent. So the word's getting out there, and if it didn't work, I don't think they would have been signing up for this. But they have a stake in it themselves as an alternate site. Those agencies that are partnering with us, they have a stake in their education. They're part of creating a pipeline to their their service. Um I'll give I'll give you an example. We have a a service uh that was a partner with ours at Murray Callaway County MS. And we have students that went across the line, went to work for them, or sorry, went to use their site as an alternate site, did their skills testing, their proctors exams, things like that there. And those were non-employee students. Now they got there, they realized, oh, I like these people, you know, I want to come work here. And now they created a recruitment tool. They helped that pipeline of paramedics come into their service, and so they're not short medics anymore.

SPEAKER_01 8:02

That's awesome. That's a uh kind of a um significant challenge to significant success in a span of what 14, 16, 16 months. So that's right.

SPEAKER_00 8:13

Awesome. And our Kentucky Board of EMS uh board meeting, one of our board members said, How can you produce a hundred paramedics in a year? I was like, Well, that's pretty gonna be pretty challenging, but we about hit that. So it's uh we're we're very happy with that.

SPEAKER_01 8:26

What are some of the lessons you learned? Because obviously, if this is your first time, there had to be some challenges. You're like, ah, we didn't think of that. What are some of the lessons learned?

SPEAKER_03 8:33

Some of the uh making sure that uh all of our programs are doing the exact same thing was one of our big things. Uh so we gave them a very clear pathway to be able to do that. Um reach having the uh yeah, making sure our hospital our clinical sites were on board with us. When we reach out to Eastern Kentucky Hospital, why is a service in Western Kentucky reached out to have students go to that hospital? Uh was one of our big clinical uh clinical things, trying to say why do you want to partner with us? Why are your students come to us? And so we had to get the the site at men, you know, and explain what we were doing and get them on board.

SPEAKER_00 9:10

That was probably our biggest challenge is getting into the hospitals. Uh, because it was weird for them, you know, like you said, why why is Hopkinsville contacting us once we explain things? And then we ended up getting 50 plus hospital partners across the state and about 75 uh agencies uh on the program.

SPEAKER_01 9:27

Um was that just a matter of uh persistence and communicating with them and overcoming falsehoods?

SPEAKER_00 9:34

Developing a local relationship to that that was a big part of it, and then from a from a program standpoint, it's keeping the students on track. You know, we we had to be very clear on what the objectives were. We didn't really start out that way, but we found out real quickly that we they're taking this flexibility a little bit too far, and uh within a month we had it adjusted and people were right on track.

SPEAKER_01 9:58

What other feedback did you get from the students throughout the process? Because obviously they're the guinea pigs for lack of better term.

SPEAKER_03 10:03

The uh the the the student the student's perspective has been great. Uh where we got multiple students who said uh if it wasn't for the flexibility of the program, they wouldn't be paramedics. We had students who lost their homes, we had students who had who had lost a fiance during this program, and because of our model, they were able to continue going with this and and overcome those adversities and become paramedics. Wow, that's good.

SPEAKER_00 10:29

Yeah, you know, life doesn't pause for pedic school, right? So we have to be flexible, and that's the component that I feel like EMS in general is basically. We're not saying this is the pathway or you know that we've been doing it wrong. We're not saying that at all. We're saying that we we created an alternative pathway to meet those non-traditional students that are able to continue when life happens, when they when the kid gets sick, whenever uh, like you said, we had Eastern Kentucky floods, so we had students over there, and so they lost their house in the flooding, and uh we're able to continue. I had one student that said he'd been in the in service for about 15 years or so uh up near Louisville, and uh he said, I've been wanting to go to med school my entire career, and this is the first time I've been able to do that because of the flexibility of the program. Now I want to emphasize it's flexible, standards are the same, the flexibility, the way it's being delivered is what's different.

SPEAKER_03 11:23

And that's one of the other things one of the other things that we have to talk about is reaching out to the students, having those those conversations, reaching out to them just as a simple text message, hey, how are you doing? I notice you're not progressing where you need to be. Um, making sure that this would this would you do awesome on this exam as a lead instructor. You did fantastic. You blew this out of the water, keep doing that. So you still build that personal relationship that you would in a cohort of six or seven. You're doing that now just on a bigger scale. You still you still have to remember at the end of the day, they're humans and they want that pet on the back.

SPEAKER_00 12:00

Yeah, you know, 110 students, it can kind of sound like, well, that's not a very parse number. It actually is because you're you're breaking that up between those 13 or 14 different sites. So they're a smaller classroom, you know, when they're doing skills, they're able to get more of a focus. But then we wanted them to feel like they were part of a small class. So we did check in on how often. We do what was called pulse checks, where every Wednesday, not every Wednesday, but occasional Wednesdays, we would get on there and students can just log in and have a conversation with us. If they needed one-on-one tutoring, they would sign up for a spot and we would meet with them and go over 12 leads, do whatever we needed to do to make sure they were successful. And I guarantee if you talked to any of our students, they would have said, I felt like the class was smaller than it actually was. I forgot the class was this big. And that's what we wanted them to feel like.

SPEAKER_03 12:43

The other thing we did was it's called muddiest points, and we did that every week. Uh if after we did our lecture, after they did their skills, after we did everything like that, we had the students, what what part of this week was the muddiest for you? What did you not understand? And then we would go through that uh that list, and if we had multiple students who said the same thing before our first class that the following week, we addressed those muddiest points to make it as clear as we could. So because it's it's a foundational knowledge, you build on each other. So you if you understand this now, it makes the next week easier to understand.

SPEAKER_01 13:19

Well, so where can um where can people that um maybe in other states, rural uh frontier states in particular, I'm thinking of, that have these same challenges, is there anywhere they can go uh to either connect with you or go through the website, I assume, uh Google it.

SPEAKER_00 13:36

Yeah, sure. Uh I don't mind giving my email out. Um I get plenty of emails all the time. So anybody that wants any any insight on what it was like to be a program director for something like this, lessons learned, that kind of stuff, uh, my email is Philip. It's actually Philip Ferguson, so it's P Ferguson, P-F-E-R-G-U-S-O-N at Hopkinsville K-Y.us. You have Pferguson at Hopkinsville K Y.us.

SPEAKER_03 14:01

And if anybody wants it from the lead instructor standpoint and going from that standpoint, my name is Mike Hornet. Uh, and again, my email is mcornett-c-o-r-n-e-t-t at hopkinsville h o p-in-s V-I-L-L-E-K-Y dotus.

SPEAKER_01 14:19

Excellent. Well, um, first of all, congratulations on the success. Uh, already 60 students have graduated. That's probably in addition to the normal 100, 110 that are being um produced or finishing their education in Kentucky. So you helped address the workforce shortage. You met the students where they are and a huge success. So kudos to you for that. And thank you for sharing your story today. Thank you very much. Thanks for having us. Thank you also for joining me. And as always, stay safe. Thank you for joining us for this episode. If you wouldn't mind, please click the like and subscribe buttons as well as the notifications so you can get notifications of upcoming episodes. Also, for the latest and greatest happenings out of the National Registry, feel free to go to NRMT.org. Thank you very much. And again, stay safe.